Digital Commons Network^™

Acknowledgment Of Culture And Stereotypes: Black Participants’ Perceptions Of Specific Therapist Behaviors, Tsotso T. Ablorh

Graduate Masters Theses

Mental health disparities for Black people of diverse ethnicities compared to people of other racial identities has been well-documented (Alegría et al., 2008; Maura & Weisman de Mamani, 2017). Research addressing this pervasive systemic and interpersonal problem often focuses on client-related factors that create or intensify barriers to care. However clinician-related factors (i.e., racial identity, multicultural training, implicit biases, behavior, etc.) also have a significant impact on barriers to care, retention in therapy, and clinical outcomes for people of African descent (Larrison & Schoppelrey, 2011; Owen, Imel, Adelson, & Rodolfa, 2012). Researchers suggest that the favoring of historically white perspectives, …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Implementing An Evidence-Based Practice Change For Alcohol Withdrawal In An Acute Care Hospital, Theresa Carroll

Student Scholarly Projects

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality.

PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the …

A Consortium Approach To Building A Recovery-Ready Community In Tooele County, Utah, Maren Wright Wright Voss, Gabriele Ciciurkaite, Erin F. Madden, Katie Zaman, Sandra H. Sulzer

Outcomes and Impact Quarterly

Substance Use Disorder (SUD) remains a critical issue in rural and tribal populations of Utah. In response, we created a consortium of recovery programs, tribal partners, social scientists, substance use disorders counselors, and treatment specialists to target prevention, treatment and recovery programming efforts in Tooele County, Utah.

The Impact Of A Crisis Intervention Team Program On Psychiatric Boarding, Kurtis Hooks

Counseling & Human Services Theses & Dissertations

Psychiatric boarding is the phenomenon of housing individuals in emergency departments while awaiting access to mental health services in the community. The expansion of psychiatric boarding is attributed to continued deinstitutionalization and under-resourcing of mental health services. Psychiatric boarding is also associated with deleterious outcomes for individuals in need of access to behavioral health services, facilities. There is limited research on programmatic efforts to reduce psychiatric boarding as it pertains to Crisis Intervention Team programs colocated in medical settings. Crisis Intervention Team (CIT) programs are community-based, multi-stakeholder partnerships that include dedicated assessment centers crisis response and referral. This study utilized …

Unmet Healthcare Need Due To Cost Concerns Among U.S. Transgender And Gender-Expansive Adults: Results From A National Survey, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Dana S. Levin, Jill Grant, Sean Esteban Mccabe

Social Work Publications

This study examines past-year unmet healthcare need due to cost experienced by transgender and gender-expansive (TGE) adults in the United States in the context of the Patient Protection and Affordable Care Act (ACA). It also aims to estimate the importance of having health insurance among TGE Americans (transgender men, transgender women, nonbinary/genderqueer people, and cross-dressers). Data were from the 2015 U.S. Transgender Survey (N ¼ 19,157 adults, aged 25 to 64 years). Multivariable logistic regression models were used to determine the adjusted odds ratios (AOR) and 95 percent confidence intervals (CI) of TGE individuals’ past-year unmet healthcare need due to …

Sex And The Streets: The Open Secret Of Sexual Abuse Among Pakistan's Two Million Street Children, Amir Humza Sohail, Muhammad Hassaan Arif Maan, Sachal Sohail

Medical College Documents

Background: About two million children live on the streets in Pakistan. Their complicated past and dire living conditions make them susceptible to many psychological and physical problems, including sexual abuse.
Main body: With little research on the topic, the prevalence of sexual intercourse among street children is reported to be as high as 88% in Pakistan. With commercial sex a common practice among the street children, public places such as bus terminals and parks have become foci of prostitution and sexual exploitation. A growing concern is the spread of HIV/AIDS among the affected children due to a general lack of …

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …

How Are Parental And Sibling Military Service Related To Adolescent Depression And Mental Health Service Use?, Andrew London

Population Health Research Brief Series

Having a parent or sibling serving in the military may lead to distress and mental health problems among adolescents. This research brief examines differences in depression and mental health service use among U.S. adolescents ages 12-17, comparing those who have parents or siblings currently serving in the military to those who do not. The study shows that adolescents are more likely to have an older sibling than a parent in the military. Although current parental military service is not associated with major depression among adolescents, having an older sibling in the military is associated with an increased probability of major …

Understanding Polarizing Community Perspectives On Harm Reduction Strategies: Challenges To Addressing The Opioid Crisis In Appalachian Pennsylvania, Stephanie L. Creasy Mph, Jessica R. Thompson Med, Christina F. Mair Phd, Jessica G. Burke Phd

Journal of Appalachian Health

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide …

Advancing Behavioral Health Literacy, James Scollione

Journal of Social, Behavioral, and Health Sciences

Accessing, comprehending, and using information to make informed decisions and improve one’s overall health or well-being are the foci of health literacy. The concept of behavioral health was introduced in the early 1980s and, since then, it has influenced new ideas (e.g., behavioral health literacy and integrated behavioral health care) and gained research and public attention. My aim is to provide an overview of definitions (i.e., health literacy, mental health literacy, and behavioral health literacy) and their connection to each other. I propose an expanded and honed definition of behavioral health literacy to enhance the behavioral health literacy and well-being …

Barred By Their Brains: Inmates With Traumatic Brain Injury (Tbi), Claire Mikita

The Scholar: St. Mary's Law Review on Race and Social Justice

Abstract forthcoming.

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

Support For Me: Provider Focus Group Summary, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Karen Pearson Mlis, Ma, Mark Richards Bs

Substance Use Research & Evaluation

This summary highlights feedback from focus groups with providers across Maine who currently address the needs of persons with substance use disorder (SUD). These providers represent individuals working in the following organizations: Health Systems, Behavioral Health Agencies, Residential Treatment, Community Recovery Programs, Opioid Treatment Programs (OTP), Emergency Medical Services (EMS), First Responders (EMT, fire, police), and law enforcement (e.g., Sheriff’s Office, Corrections). This summary report is designed to provide feedback to the Office of MaineCare Services to help inform their strategic planning process to increase statewide capacity for SUD treatment and recovery service capacity to better meet the needs of …

From Ridicule To Reform: Potential Solutions To The Domestic Violence Crisis, Kelly Gordon

Undergraduate Research Symposium

During the grassroots campaigns of the 1970s, American citizens saw a rise of concern for victims of domestic violence. The knowledge gathered over the past half-century has explained the detrimental effects intimate partner violence has on victims, the potential reasons partners become violent, and the most effective approaches to ending this epidemic. To curve the high rates of recidivation seen among domestic violence offenders, current rehabilitation programs must change to mirror the needs of the abuser. A new approach, Achieving Change Through Values-Based Behavior (ACTV), works to address comorbidities that potentially prevent offenders from shaking off their violent pasts. This …

A Decarceral Cadence: Neurologic Music Therapy As An Abolitionist Project, Mallori D. Thompson, Richard A. Kirby

Connecticut Law Review

Because police and prison abolition must be approached while simultaneously improving quality of life, and thus reducing harm, abolitionist discourse should include health policies that regard the (de)regulation, use, and culture of addictive substances. This Essay calls for research into neurologic music therapy as a response to addiction, improving quality of life and paving the way for police and prison abolition.

Among Patients With A Dual Diagnosis Of Schizophrenia And Substance Use Disorder What Current Treatments Provide Optimal Outcomes?, Drew Mcnamara

Theses and Graduate Projects

Introduction: This research was conducted on the topic of dual diagnosis (DD) patients with co-occurring schizophrenia (SZ) and substance use disorder (SUD). The research question posed for this topic: among patients with a DD of SZ and SUD what current treatments offer optimal outcomes?

Methods: The research for this paper was predominantly a literature review. Forty-five sources were utilized in its construction. The majority of sources were peer-reviewed studies obtained from an online service via the Lindell Library at Augsburg University. Three textbooks were utilized. One expert interview was conducted.

Results: Three key findings within the research identified first, SUD …

Pilot Testing A Survey Instrument To Evaluate Eaat Professionals' Views On The Effects Of Equine-Assisted Activities And Therapies On Hope And Depression In Court-Involved Youth, Emily Stewart

Animal Science Undergraduate Honors Theses

Equine Assisted Activity and Therapy (EAAT) programs have proven beneficial for individuals with mental, physical and psychological ailments. Only in the last few years have court systems begun to utilize the complex nature of the human-horse relationship to benefit the lives of court-involved youth. Despite its novelty, the few existing studies in this field yield positive results (Frederick et al., 2015). To address the need for further research in this area, a pilot study was conducted. An exploratory survey was given to EAAT professionals to determine their views on the effects of EAAT programs on hope and depression in court-involved …

Alcohol Use In Women: Resources And Recommendations For Counselors, Samantha Haling

Educational Specialist, 2020-current

The research shows that alcohol use is rising rapidly among women, resulting in devastating consequences that have not been sufficiently explored in counselor education and training. This paper aims to address this by providing a review of the literature which shows that women are more vulnerable to many of the physical and mental health consequences of alcohol use than men, and that they have unique treatment needs and face gender-specific risk factors and barriers to treatment. The review examines the interaction between gender and alcohol use, summarizes the existing research on the physical and behavioral health consequences of alcohol use …

“I Want Justice From People Who Did Bad Things To Children”: Experiences Of Justice For Sex Trafficking Survivors, John G. Morrissey, James Havey, Glenn M. Miles, Nhanh Channtha, Lim Vanntheary

Dignity: A Journal of Analysis of Exploitation and Violence

This research from the Butterfly Longitudinal Research Project focused on understanding the experiences and perceptions of justice and the justice system for 93 Cambodia participants (including 88 survivors of sex trafficking) as they navigated the legal system. Thirty-two of these survivors had experiences in court and provided details into their courtroom experiences, predominantly within Cambodia but also in the United States. The survivors’ experiences were diverse; however, the prevailing themes were: fear throughout their legal journeys; a low level of awareness and understanding of their legal experiences; and that NGO support was essential for these survivors to engage in the …

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

The Relationship Between Emotion Regulation And Substance Use Treatment Attrition, Melanie Ruth Roys

LSU Doctoral Dissertations

Severe substance use disorders are characterized by chronic cycles of relapse; however, individuals who complete substance use treatment are less likely to experience relapse. Research has focused on trying to identify factors that predict treatment dropout to help improve treatment outcomes. Most of this research has focused on examining demographic and patient-specific factors, with little success in reliably predicting treatment attrition. There has been less focus on investigating transdiagnostic factors that span across discrete psychological diagnoses and demographics. The present study sought to determine if self-report and behavioral measures related to emotion regulation predicted inpatient substance use treatment dropout above …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

The Effects Of Mental Illness On Capital Sentencing In The State Of Oregon, Mirtill E. Csikos

University Honors Theses

There is emerging awareness on the potential arbitrariness and unconstitutionality of executing persons with mental illness. Most states with current death penalty laws have little to no protection for severely mentally ill defendants during capital trials. The present paper looked at the effectiveness of sentencing statutes serving the purpose of protecting defendants with severe mental illness in the state of Oregon. Through a careful meta-analysis this research focused on determining how mental illness plays into death penalty decisions and if Oregon’s Guilty Except for Insanity defense provides sufficient protection. Furthermore, the question of mental illness as a mitigating factor was …

Child-Centered Play Therapy’S Impact On Externalized Behaviors Of Children Who Have Experienced Trauma: A Single-Case Research Design, Timothy "T.J." Schoonover

Graduate Theses and Dissertations

Adverse childhood experiences (ACEs) are defined as exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, loss of a parent, domestic violence, family member with addiction, family member with depression or mental illness, and family member incarcerated (Felitti et al., 1998). ACEs have been studied for many years and have shown to have long term negative health and social-emotional outcomes and costs the world over $1 trillion a year (Bellis et al., 2019; Felitti et al., 1998; Hughes et al., 2017). Due to the emotional, physical, and dollar amount cost to not addressing the impact of ACEs …

An Investigation Of Occupational Therapy Utilizing Sensory Modulation To Manage Co-Morbid Chronic Pain And Substance Use In Order To Promote Occupational Performance And Recovery, Claire Ruth

Student Capstone Papers

Background: Those with chronic pain have worse drug and alcohol treatment outcomes and higher rates of relapse compared to those without pain or with reduced pain (Ilgen et al., 2020).

Methods: A descriptive study was employed with the aim of determining what are the sensory processing pattens of those with co-morbid chronic pain and in recovery for substance use. All participants completed the Adolescent and Adult Sensory Profile, the Brief Pain Inventory, and the Personal Recovery Outcome Measure (PROM).

Results: From the preliminary findings, individuals with co-morbid chronic pain and substance use may have atypical sensory processing …

Social Determinants Of Health And Care Outcomes Among People With Hiv In The United States, Timothy W. Menza, Lindsay K. Hixson, Lauren E. Lipira, Linda Drach

Regional Research Institute for Human Services

Fewer than 70% of people with HIV (PWH) in the United States have achieved durable viral suppression. To end the HIV epidemic in the United States, clinicians, researchers, and public health practitioners must devise ways to remove barriers to effective HIV treatment. To identify PWH who experience challenges to accessing health care, we created a simple assessment of social determinants of health (SDOH) among PWH and examined the impact of cumulative social and economic disadvantage on key HIV care outcomes.

Understanding The Stigma And Feasibility Of Opening A Safe Injection Facility In Baltimore City: A Qualitative Case Study, Timothy Dupree, Caroline I. Wood, Andrea M. Brace

The Qualitative Report

Supervised injection facilities (SIFs) are medically supervised facilities designed to provide a hygienic environment in which drug users can consume illicit drugs intravenously. SIFs can be cost saving, help to reduce transmission of disease, and decrease drug overdoses. There are no SIFs in the United States. In this study we used a multiple case study design to understand the stigma surrounding the use of a SIF and the feasibility of implementing the drug prevention strategy in Baltimore City by comparing experiences with opening a SIF in Sydney, Australia. We interviewed one healthcare worker at the Sydney SIF and ten community …

A Systematic Review Of Mental Illness, Criminogenic Risk, And The U.S. Prison System, Eliza Esquibel

Student Works

The incarceration rates in the United States are the highest in the world. Within the U.S. prison population, mental illness is overrepresented as compared to the general population. The present study examined existing literature that researched the connection between the prison system and mental illness, and the potential solutions to this crisis. The studies looked at focused on psychiatric disorders, substance disorders, and trauma. They also focused on the intersection between race, mental illness, and the prison system, and the intersection between mental illness, gender, and the prison system. These studies revealed a high prevalence of untreated mental illness in …